Skip to main content
Erschienen in: European Radiology 2/2019

24.07.2018 | Gastrointestinal

Magnetic resonance elastography can predict development of hepatocellular carcinoma with longitudinally acquired two-point data

verfasst von: Shintaro Ichikawa, Utaroh Motosugi, Nobuyuki Enomoto, Hiroshi Onishi

Erschienen in: European Radiology | Ausgabe 2/2019

Einloggen, um Zugang zu erhalten

Abstract

Objective

To evaluate the usefulness of longitudinal observation of liver stiffness measured using magnetic resonance elastography (MRE) to stratify the risk of hepatocellular carcinoma (HCC) in patients with chronic liver disease.

Materials and methods

We retrospectively reviewed data for 161 patients with chronic liver disease using the following inclusion criteria: two MRE examinations separated by at least a 12-month interval, no history of HCC, no development of HCC between the two examinations and availability of laboratory results. Liver stiffness was classified as low (< 3 kPa), moderate (3–4.7 kPa) or high (> 4.7 kPa). The patients were divided into three groups according to sequential changes in liver stiffness as follows: high on the first MRE (group A, n = 60), low on both MRE examinations (group C, n = 36) and other combinations (group B, n = 65). Cox analyses and Kaplan-Meier methods were used to determine the risk of developing HCC.

Results

Forty-seven patients (29.2%) developed HCC during follow-up (46.7% [28/60] in group A, 26.2% [17/65] in group B, and 5.6% [2/36] in group C). There was a significant difference in the rate of development of HCC between groups A (45.1%), B (26.1%) and C (12.4%) at 3 years (p = 0.0002). The independent risk factors for development of HCC were group A classification, age and a high alanine aminotransferase level (risk ratio 1.018–6.030; p = 0.0028–0.0268).

Conclusion

Longitudinal observation of liver stiffness using MRE can stratify the risk of HCC during follow-up of chronic liver disease.

Key Points

• The results of MRE can stratify the risk for development of HCC during follow-up in patients with chronic liver disease.
• Patients with chronic liver disease and high liver stiffness (> 4.7 kPa) on a previous MRE examination are at high risk for developing HCC, regardless of current liver stiffness.
• Management of patients with chronic liver disease becomes more appropriate using longitudinally acquired two-point MRE data.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Wong VW, Janssen HL (2015) Can we use HCC risk scores to individualize surveillance in chronic hepatitis B infection? J Hepatol 63:722–732CrossRefPubMed Wong VW, Janssen HL (2015) Can we use HCC risk scores to individualize surveillance in chronic hepatitis B infection? J Hepatol 63:722–732CrossRefPubMed
2.
Zurück zum Zitat Sugino Y, Yamakado K, Yamanaka T et al (2017) Role of curative treatment in patients with intermediate-stage hepatocellular carcinoma. Jpn J Radiol 35:254–261CrossRefPubMed Sugino Y, Yamakado K, Yamanaka T et al (2017) Role of curative treatment in patients with intermediate-stage hepatocellular carcinoma. Jpn J Radiol 35:254–261CrossRefPubMed
3.
Zurück zum Zitat Takyar V, Etzion O, Heller T et al (2017) Complications of percutaneous liver biopsy with Klatskin needles: a 36-year single-centre experience. Aliment Pharmacol Ther 45:744–753CrossRefPubMedPubMedCentral Takyar V, Etzion O, Heller T et al (2017) Complications of percutaneous liver biopsy with Klatskin needles: a 36-year single-centre experience. Aliment Pharmacol Ther 45:744–753CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Chindamo MC, Nunes-Pannain VL, Araújo-Neto JM et al (2015) Intermediate fibrosis staging in hepatitis C: a problem not overcome by optimal samples or pathologists' expertise. Ann Hepatol 14:652–657PubMed Chindamo MC, Nunes-Pannain VL, Araújo-Neto JM et al (2015) Intermediate fibrosis staging in hepatitis C: a problem not overcome by optimal samples or pathologists' expertise. Ann Hepatol 14:652–657PubMed
5.
Zurück zum Zitat Huang Z, Zheng W, Zhang YJ et al (2017) Assessing hepatic fibrosis using 2-D shear wave elastography in patients with liver tumors: a prospective single-center study. Ultrasound Med Biol 43:2522–2529CrossRefPubMed Huang Z, Zheng W, Zhang YJ et al (2017) Assessing hepatic fibrosis using 2-D shear wave elastography in patients with liver tumors: a prospective single-center study. Ultrasound Med Biol 43:2522–2529CrossRefPubMed
6.
Zurück zum Zitat Wang T, Shao C, Zhang G, Xu Y (2017) Real-time elastography (RTE): a valuable sonography-based non-invasive method for the assessment of liver fibrosis in chronic hepatitis B. Abdom Radiol (NY) 42:2632–2638CrossRef Wang T, Shao C, Zhang G, Xu Y (2017) Real-time elastography (RTE): a valuable sonography-based non-invasive method for the assessment of liver fibrosis in chronic hepatitis B. Abdom Radiol (NY) 42:2632–2638CrossRef
7.
Zurück zum Zitat Masuzaki R, Tateishi R, Yoshida H et al (2008) Risk assessment of hepatocellular carcinoma in chronic hepatitis C patients by transient elastography. J Clin Gastroenterol 42:839–843CrossRefPubMed Masuzaki R, Tateishi R, Yoshida H et al (2008) Risk assessment of hepatocellular carcinoma in chronic hepatitis C patients by transient elastography. J Clin Gastroenterol 42:839–843CrossRefPubMed
8.
Zurück zum Zitat Park MS, Han KH, Kim SU (2014) Non-invasive prediction of development of hepatocellular carcinoma using transient elastography in patients with chronic liver disease. Expert Rev Gastroenterol Hepatol 8:501–511CrossRefPubMed Park MS, Han KH, Kim SU (2014) Non-invasive prediction of development of hepatocellular carcinoma using transient elastography in patients with chronic liver disease. Expert Rev Gastroenterol Hepatol 8:501–511CrossRefPubMed
9.
Zurück zum Zitat Ichikawa S, Motosugi U, Enomoto N, Matsuda M, Onishi H (2017) Noninvasive hepatic fibrosis staging using MR elastography: the usefulness of the bayesian prediction method. J Magn Reson Imaging 46:375–382CrossRefPubMed Ichikawa S, Motosugi U, Enomoto N, Matsuda M, Onishi H (2017) Noninvasive hepatic fibrosis staging using MR elastography: the usefulness of the bayesian prediction method. J Magn Reson Imaging 46:375–382CrossRefPubMed
10.
Zurück zum Zitat Yin M, Glaser KJ, Talwalkar JA, Chen J, Manduca A, Ehman RL (2016) Hepatic MR elastography: clinical performance in a series of 1377 consecutive examinations. Radiology 278:114–124CrossRefPubMed Yin M, Glaser KJ, Talwalkar JA, Chen J, Manduca A, Ehman RL (2016) Hepatic MR elastography: clinical performance in a series of 1377 consecutive examinations. Radiology 278:114–124CrossRefPubMed
11.
Zurück zum Zitat Kim SU, Kim BK, Park JY et al (2016) Transient elastography is superior to FIB-4 in assessing the risk of hepatocellular carcinoma in patients with chronic hepatitis B. Medicine (Baltimore) 95:e3434CrossRef Kim SU, Kim BK, Park JY et al (2016) Transient elastography is superior to FIB-4 in assessing the risk of hepatocellular carcinoma in patients with chronic hepatitis B. Medicine (Baltimore) 95:e3434CrossRef
12.
Zurück zum Zitat Motosugi U, Ichikawa T, Koshiishi T et al (2013) Liver stiffness measured by magnetic resonance elastography as a risk factor for hepatocellular carcinoma: a preliminary case-control study. Eur Radiol 23:156–162CrossRefPubMed Motosugi U, Ichikawa T, Koshiishi T et al (2013) Liver stiffness measured by magnetic resonance elastography as a risk factor for hepatocellular carcinoma: a preliminary case-control study. Eur Radiol 23:156–162CrossRefPubMed
13.
Zurück zum Zitat Heimbach JK, Kulik LM, Finn RS et al (2018) AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology 67:358–380CrossRefPubMed Heimbach JK, Kulik LM, Finn RS et al (2018) AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology 67:358–380CrossRefPubMed
15.
Zurück zum Zitat Rouviere O, Yin M, Dresner MA et al (2006) MR elastography of the liver: preliminary results. Radiology 240:440–448CrossRefPubMed Rouviere O, Yin M, Dresner MA et al (2006) MR elastography of the liver: preliminary results. Radiology 240:440–448CrossRefPubMed
16.
Zurück zum Zitat Yin M, Talwalkar JA, Glaser KJ et al (2007) Assessment of hepatic fibrosis with magnetic resonance elastography. Clin Gastroenterol Hepatol 5:1207–1213.e2CrossRefPubMedPubMedCentral Yin M, Talwalkar JA, Glaser KJ et al (2007) Assessment of hepatic fibrosis with magnetic resonance elastography. Clin Gastroenterol Hepatol 5:1207–1213.e2CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Manduca A, Oliphant TE, Dresner MA et al (2001) Magnetic resonance elastography: non-invasive mapping of tissue elasticity. Med Image Anal 5:237–254CrossRefPubMed Manduca A, Oliphant TE, Dresner MA et al (2001) Magnetic resonance elastography: non-invasive mapping of tissue elasticity. Med Image Anal 5:237–254CrossRefPubMed
18.
Zurück zum Zitat Talwalkar JA, Yin M, Venkatesh S et al (2009) Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension. AJR Am J Roentgenol 193:122–127CrossRefPubMedPubMedCentral Talwalkar JA, Yin M, Venkatesh S et al (2009) Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension. AJR Am J Roentgenol 193:122–127CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Wang JH, Chuah SK, Lu SN et al (2014) Baseline and serial liver stiffness measurement in prediction of portal hypertension progression for patients with compensated cirrhosis. Liver Int 34:1340–1348CrossRefPubMed Wang JH, Chuah SK, Lu SN et al (2014) Baseline and serial liver stiffness measurement in prediction of portal hypertension progression for patients with compensated cirrhosis. Liver Int 34:1340–1348CrossRefPubMed
20.
Zurück zum Zitat Coulon S, Heindryckx F, Geerts A, Van Steenkiste C, Colle I, Van Vlierberghe H (2011) Angiogenesis in chronic liver disease and its complications. Liver Int 31:146–162CrossRefPubMed Coulon S, Heindryckx F, Geerts A, Van Steenkiste C, Colle I, Van Vlierberghe H (2011) Angiogenesis in chronic liver disease and its complications. Liver Int 31:146–162CrossRefPubMed
21.
Zurück zum Zitat Machado MV, Cortez-Pinto H (2015) Proangiogenic factors in the development of HCC in alcoholic cirrhosis. Clin Res Gastroenterol Hepatol 39(Suppl 1):S104–S108CrossRef Machado MV, Cortez-Pinto H (2015) Proangiogenic factors in the development of HCC in alcoholic cirrhosis. Clin Res Gastroenterol Hepatol 39(Suppl 1):S104–S108CrossRef
22.
Zurück zum Zitat Bartolomeo N, Trerotoli P, Serio G (2011) Progression of liver cirrhosis to HCC: an application of hidden Markov model. BMC Med Res Methodol 11:38CrossRefPubMedPubMedCentral Bartolomeo N, Trerotoli P, Serio G (2011) Progression of liver cirrhosis to HCC: an application of hidden Markov model. BMC Med Res Methodol 11:38CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Guo J, Büning C, Schott E et al (2015) In vivo abdominal magnetic resonance elastography for the assessment of portal hypertension before and after transjugular intrahepatic portosystemic shunt implantation. Invest Radiol 50:347–351CrossRefPubMed Guo J, Büning C, Schott E et al (2015) In vivo abdominal magnetic resonance elastography for the assessment of portal hypertension before and after transjugular intrahepatic portosystemic shunt implantation. Invest Radiol 50:347–351CrossRefPubMed
24.
Zurück zum Zitat Morisaka H, Motosugi U, Ichikawa S et al (2015) Association of splenic MR elastographic findings with gastroesophageal varices in patients with chronic liver disease. J Magn Reson Imaging 41:117–124CrossRefPubMed Morisaka H, Motosugi U, Ichikawa S et al (2015) Association of splenic MR elastographic findings with gastroesophageal varices in patients with chronic liver disease. J Magn Reson Imaging 41:117–124CrossRefPubMed
25.
Zurück zum Zitat Asrani SK, Talwalkar JA, Kamath PS et al (2014) Role of magnetic resonance elastography in compensated and decompensated liver disease. J Hepatol 60:934–939CrossRefPubMed Asrani SK, Talwalkar JA, Kamath PS et al (2014) Role of magnetic resonance elastography in compensated and decompensated liver disease. J Hepatol 60:934–939CrossRefPubMed
26.
Zurück zum Zitat Takamura T, Motosugi U, Ichikawa S et al (2016) Usefulness of MR elastography for detecting clinical progression of cirrhosis from child-pugh class A to B in patients with type C viral hepatitis. J Magn Reson Imaging 44:715–722CrossRefPubMed Takamura T, Motosugi U, Ichikawa S et al (2016) Usefulness of MR elastography for detecting clinical progression of cirrhosis from child-pugh class A to B in patients with type C viral hepatitis. J Magn Reson Imaging 44:715–722CrossRefPubMed
27.
Zurück zum Zitat Thompson SM, Wang J, Chandan VS et al (2017) MR elastography of hepatocellular carcinoma: correlation of tumor stiffness with histopathology features—preliminary findings. Magn Reson Imaging 37:41–45CrossRefPubMed Thompson SM, Wang J, Chandan VS et al (2017) MR elastography of hepatocellular carcinoma: correlation of tumor stiffness with histopathology features—preliminary findings. Magn Reson Imaging 37:41–45CrossRefPubMed
28.
Zurück zum Zitat Hennedige TP, Hallinan JT, Leung FP et al (2016) Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions. Eur Radiol 26:398–406CrossRefPubMed Hennedige TP, Hallinan JT, Leung FP et al (2016) Comparison of magnetic resonance elastography and diffusion-weighted imaging for differentiating benign and malignant liver lesions. Eur Radiol 26:398–406CrossRefPubMed
29.
Zurück zum Zitat Gordic S, Ayache JB, Kennedy P et al (2017) Value of tumor stiffness measured with MR elastography for assessment of response of hepatocellular carcinoma to locoregional therapy. Abdom Radiol (NY) 42:1685–1694CrossRef Gordic S, Ayache JB, Kennedy P et al (2017) Value of tumor stiffness measured with MR elastography for assessment of response of hepatocellular carcinoma to locoregional therapy. Abdom Radiol (NY) 42:1685–1694CrossRef
30.
Zurück zum Zitat Lee DH, Lee JM, Yi NJ et al (2017) Hepatic stiffness measurement by using MR elastography: prognostic values after hepatic resection for hepatocellular carcinoma. Eur Radiol 27:1713–1721CrossRefPubMed Lee DH, Lee JM, Yi NJ et al (2017) Hepatic stiffness measurement by using MR elastography: prognostic values after hepatic resection for hepatocellular carcinoma. Eur Radiol 27:1713–1721CrossRefPubMed
31.
Zurück zum Zitat Crespo G, Castro-Narro G, García-Juárez I et al (2016) Usefulness of liver stiffness measurement during acute cellular rejection in liver transplantation. Liver Transpl 22:298–304CrossRefPubMed Crespo G, Castro-Narro G, García-Juárez I et al (2016) Usefulness of liver stiffness measurement during acute cellular rejection in liver transplantation. Liver Transpl 22:298–304CrossRefPubMed
32.
Zurück zum Zitat Anthony PP, Ishak KG, Nayak NC et al (1978) The morphology of cirrhosis. Recommendations on definition, nomenclature, and classification by a working group sponsored by the World Health Organization. J Clin Pathol 31:395–414CrossRefPubMedPubMedCentral Anthony PP, Ishak KG, Nayak NC et al (1978) The morphology of cirrhosis. Recommendations on definition, nomenclature, and classification by a working group sponsored by the World Health Organization. J Clin Pathol 31:395–414CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat D'Amico G, Garcia-Tsao G, Pagliaro L (2006) Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol 44:217–231CrossRefPubMed D'Amico G, Garcia-Tsao G, Pagliaro L (2006) Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol 44:217–231CrossRefPubMed
34.
Zurück zum Zitat Shiratori Y, Imazeki F, Moriyama M et al (2000) Histologic improvement of fibrosis in patients with hepatitis C who have sustained response to interferon therapy. Ann Intern Med 132:517–524CrossRefPubMed Shiratori Y, Imazeki F, Moriyama M et al (2000) Histologic improvement of fibrosis in patients with hepatitis C who have sustained response to interferon therapy. Ann Intern Med 132:517–524CrossRefPubMed
35.
Zurück zum Zitat Kim SU, Oh HJ, Wanless IR et al (2012) The Laennec staging system for histological sub-classification of cirrhosis is useful for stratification of prognosis in patients with liver cirrhosis. J Hepatol 57:556–563CrossRefPubMed Kim SU, Oh HJ, Wanless IR et al (2012) The Laennec staging system for histological sub-classification of cirrhosis is useful for stratification of prognosis in patients with liver cirrhosis. J Hepatol 57:556–563CrossRefPubMed
36.
Zurück zum Zitat Wang W, Li J, Pan R et al (2015) Association of the Laennec staging system with degree of cirrhosis, clinical stage and liver function. Hepatol Int 9:621–626CrossRefPubMed Wang W, Li J, Pan R et al (2015) Association of the Laennec staging system with degree of cirrhosis, clinical stage and liver function. Hepatol Int 9:621–626CrossRefPubMed
37.
Zurück zum Zitat Kim SU, Kim JK, Park YN et al (2012) Discordance between liver biopsy and Fibroscan® in assessing liver fibrosis in chronic hepatitis b: risk factors and influence of necroinflammation. PLoS One 7:e32233CrossRefPubMedPubMedCentral Kim SU, Kim JK, Park YN et al (2012) Discordance between liver biopsy and Fibroscan® in assessing liver fibrosis in chronic hepatitis b: risk factors and influence of necroinflammation. PLoS One 7:e32233CrossRefPubMedPubMedCentral
38.
Zurück zum Zitat Krawczyk M, Ligocka J, Ligocki M et al (2017) Does transient elastography correlate with liver fibrosis in patients with PSC? Laennec score-based analysis of explanted livers. Scand J Gastroenterol 52:1407–1412CrossRefPubMed Krawczyk M, Ligocka J, Ligocki M et al (2017) Does transient elastography correlate with liver fibrosis in patients with PSC? Laennec score-based analysis of explanted livers. Scand J Gastroenterol 52:1407–1412CrossRefPubMed
39.
Zurück zum Zitat Yoshida H, Shiratori Y, Moriyama M et al (1999) Interferon therapy reduces the risk for hepatocellular carcinoma: national surveillance program of cirrhotic and noncirrhotic patients with chronic hepatitis C in Japan. IHIT Study Group. Inhibition of Hepatocarcinogenesis by Interferon Therapy. Ann Intern Med 131:174–181CrossRefPubMed Yoshida H, Shiratori Y, Moriyama M et al (1999) Interferon therapy reduces the risk for hepatocellular carcinoma: national surveillance program of cirrhotic and noncirrhotic patients with chronic hepatitis C in Japan. IHIT Study Group. Inhibition of Hepatocarcinogenesis by Interferon Therapy. Ann Intern Med 131:174–181CrossRefPubMed
40.
Zurück zum Zitat Tran SA, Le A, Zhao C et al (2008) Rate of hepatocellular carcinoma surveillance remains low for a large, real-life cohort of patients with hepatitis C cirrhosis. BMJ Open Gastroenterol 5:e000192CrossRef Tran SA, Le A, Zhao C et al (2008) Rate of hepatocellular carcinoma surveillance remains low for a large, real-life cohort of patients with hepatitis C cirrhosis. BMJ Open Gastroenterol 5:e000192CrossRef
41.
Zurück zum Zitat Ichikawa S, Motosugi U, Nakazawa T et al (2015) Hepatitis activity should be considered a confounder of liver stiffness measured with MR elastography. J Magn Reson Imaging 41:1203–1208CrossRefPubMed Ichikawa S, Motosugi U, Nakazawa T et al (2015) Hepatitis activity should be considered a confounder of liver stiffness measured with MR elastography. J Magn Reson Imaging 41:1203–1208CrossRefPubMed
42.
Zurück zum Zitat Yoshimitsu K, Mitsufuji T, Shinagawa Y et al (2016) MR elastography of the liver at 3.0 T in diagnosing liver fibrosis grades; preliminary clinical experience. Eur Radiol 26:656–663CrossRefPubMed Yoshimitsu K, Mitsufuji T, Shinagawa Y et al (2016) MR elastography of the liver at 3.0 T in diagnosing liver fibrosis grades; preliminary clinical experience. Eur Radiol 26:656–663CrossRefPubMed
43.
Zurück zum Zitat Shi Y, Guo Q, Xia F et al (2014) MR elastography for the assessment of hepatic fibrosis in patients with chronic hepatitis B infection: does histologic necroinflammation influence the measurement of hepatic stiffness? Radiology 273:88–98CrossRefPubMed Shi Y, Guo Q, Xia F et al (2014) MR elastography for the assessment of hepatic fibrosis in patients with chronic hepatitis B infection: does histologic necroinflammation influence the measurement of hepatic stiffness? Radiology 273:88–98CrossRefPubMed
44.
Zurück zum Zitat Chhatwal J, Wang X, Ayer T et al (2016) Hepatitis C disease burden in the United States in the era of oral direct-acting antivirals. Hepatology 64:1442–1450CrossRefPubMed Chhatwal J, Wang X, Ayer T et al (2016) Hepatitis C disease burden in the United States in the era of oral direct-acting antivirals. Hepatology 64:1442–1450CrossRefPubMed
45.
Zurück zum Zitat Alexopoulou A, Karayiannis P (2015) Interferon-based combination treatment for chronic hepatitis C in the era of direct acting antivirals. Ann Gastroenterol 28:55–65PubMedPubMedCentral Alexopoulou A, Karayiannis P (2015) Interferon-based combination treatment for chronic hepatitis C in the era of direct acting antivirals. Ann Gastroenterol 28:55–65PubMedPubMedCentral
46.
Zurück zum Zitat Kanwal F, Kramer J, Asch SM, Chayanupatkul M, Cao Y, El-Serag HB (2017) Risk of hepatocellular cancer in HCV patients treated with direct acting antiviral agents. Gastroenterology 153:996–1005.e1CrossRefPubMed Kanwal F, Kramer J, Asch SM, Chayanupatkul M, Cao Y, El-Serag HB (2017) Risk of hepatocellular cancer in HCV patients treated with direct acting antiviral agents. Gastroenterology 153:996–1005.e1CrossRefPubMed
47.
Zurück zum Zitat Ogata F, Kobayashi M, Akuta N et al (2017) Outcome of all-oral direct-acting antiviral regimens on the rate of development of hepatocellular carcinoma in patients with hepatitis C virus genotype 1-related chronic liver disease. Oncology 93:92–98CrossRefPubMed Ogata F, Kobayashi M, Akuta N et al (2017) Outcome of all-oral direct-acting antiviral regimens on the rate of development of hepatocellular carcinoma in patients with hepatitis C virus genotype 1-related chronic liver disease. Oncology 93:92–98CrossRefPubMed
Metadaten
Titel
Magnetic resonance elastography can predict development of hepatocellular carcinoma with longitudinally acquired two-point data
verfasst von
Shintaro Ichikawa
Utaroh Motosugi
Nobuyuki Enomoto
Hiroshi Onishi
Publikationsdatum
24.07.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 2/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5640-7

Weitere Artikel der Ausgabe 2/2019

European Radiology 2/2019 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.